Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T16:07:34.216Z Has data issue: false hasContentIssue false

Agoraphobia with panic attacks and social phobia: a comparative clinical and psychometric study

Published online by Cambridge University Press:  28 April 2020

J. Cottraux
Affiliation:
Laboratoire de Psychologie Médicale, Hôpital Neurologique, 59, boulevard Pinel, 69394Lyon, France
E. Mollard
Affiliation:
Laboratoire de Psychologie Médicale, Hôpital Neurologique, 59, boulevard Pinel, 69394Lyon, France
A. Duinat-pascal
Affiliation:
Laboratoire de Psychologie Médicale, Hôpital Neurologique, 59, boulevard Pinel, 69394Lyon, France
Get access

Summary

Seventy one agoraphobie patients with panic attacks, and 54 social phobics, diagnosed according to DSM III criteria have been compared. The two groups were balanced for age, sex, and educational level. Statistical comparisons of clinical, and psychometric variables differentiated the two groups. Panic attacks frequency characterized the agoraphobie patients, while very low assertion scores on Radius’ Assertiveness Schedule characterized social phobies. An association with simple phobias was more frequently found in agoraphobic patients. Comparable levels of generalized anxiety and avoidance were found in the two groups. MMPI mean profile was more disturbed in social phobics. Psychasthenia scale, and anxiety index, were significantly higher in social phobics. Social phobias started earlier, but these patients sought treatment later, and took less psychotropic medication. There was no correlation between assertiveness and panic attacks frequency in the two sub-samples. Principal components analysis of MMPI scales and Assertiveness Schedule confirmed the heterogeneity of the two syndromes. Results are discussed in regard of the extensive use of panic attacks as a general model of anxiety.

Résumé

Résumé

Soixante et onze patients présentant une agoraphobie avec attaques de panique et 54 phobiques sociaux, diagnostiqués selon les critères du DSM III sont comparés. Les deux groupes ne présentaient pas de différence statistiquement significative quant à l’âge, le sexe, et le niveau d'éducation. La comparaison statistique des variables cliniques et psychométriques différenciait les deux groupes. La fréquence des attaques de panique caractérisait les patients agoraphobes, tandis que des scores très bas sur l’échelle d’affirmation de soi de Rathus caractérisaient les phobiques sociaux. Une association avec les phobies simples était plus fréquemment retrouvées chez les agoraphobes. Le même niveau d’anxiété généralisée et d’évitement était retrouvé dans les deux groupes. Le profil moyen du MMPI était plus pathologique chez les phobiques sociaux. L’échelle de psychasthénie, et l‘index d‘anxiété, étaient significativement plus élevés chez les phobiques sociaux. Les phobies sociales débutaient plus tôt, mais demandaient un traitement plus tard, et prenaient moins de médication psychotrope. Il n‘y avait pas de corrélation entre la fréquence des attaques de panique et le niveau d ‘affirmation de soi sur l’échelle de Rathus. L’analyse en composante principale des échelles du MMPI et de l’échelle d‘affirmation de soi de Rathus confirmait l‘hétérogénéité des deux syndromes. Les résultats sont discutés par rapport à l’usage extensif du concept d’attaque de panique comme modèle général de l’anxiété.

Type
Original article
Copyright
Copyright © European Psychiatric Association 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

An earlier version of this paper was presented orally at the European Association of Behaviour Therapy, Lausanne (Switzerland), September 9, 1986.

References

American, Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. A.P.A., Washington, D.C.Google Scholar
American, Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders, 3rd edn A.P.A., Washington, D.C.Google Scholar
Amies, P.Gelder, M. & Shaw, P. (1983) Social phobia: A comparative clinical study. Brit. J. Psychiat. 142, 174179CrossRefGoogle ScholarPubMed
Bouvard, M.Cottraux, J.Mollard, M.Messy, Ph. & Defayolle, M. (1986) Validation et analyse factorielle de l’échelle d’affirmation de soi de Rathus. Psychol. Méd. 18, 759763Google Scholar
Chambless, D.Hunter, K. & Jackson, A. (1982) Social anxiety and assertiveness: a comparison of the correlations in phobie and college student samples. Behav. Res. Ther. 20, 403404CrossRefGoogle Scholar
Cottraux, J.Duinat, A. & Mollard, E. (1986) Agoraphobie avec attaques de panique: caractéristiques chez l’homme et chez la femme. Évolution après thérapie comportementale. Entretiens de Bichat. Expansion Scientifique Française, ParisGoogle Scholar
Fisher, L. & Wilson, T. (1985) A study of the psychology of agoraphobia. Behav. Res. Ther. 23, 97107CrossRefGoogle ScholarPubMed
Goldstein, A.J. & Chambless, D.J. (1978) A re-analysis of agoraphobia. Behav. Ther. 9, 4759CrossRefGoogle Scholar
Greene, R. (1980) The MMPI An Interpretative Manual. Grune and Straton, LondonGoogle Scholar
Liebowitz, M.Gorman, J.Fyer, A. & Klein, D. (1985a) Social phobia. Review of a neglected anxiety disorder. Arch. Gen. Psychiatry 42, 729736CrossRefGoogle Scholar
Liebowitz, M.Fyer, A.Gorman, J.Dillon, D.Davies, S.Stein, J.Cohen, B. & Klein, D. (1985b) Specificity of lactate infusions in social phobia versus panic disorders. Am. J. Psychiatry 142, 947950Google Scholar
Marks, I. (1970) The classification of phobic disorders. Brit. J. Psychiat. 116, 377386CrossRefGoogle ScholarPubMed
Marks, I.Hallam, R.Connoly, J. & Philpott, R. (1977) Nursing in Behavioural Psychotherapy. An Advanced Clinical Role for Nurses. Whitefriars, London and TonbridgeGoogle Scholar
Mavissakalian, M. (1985) Male and female agoraphobia: are they different?. Behav. Res. Ther. 23, 469471CrossRefGoogle ScholarPubMed
Myers, J.Weissmann, G.Tischler, G.Holzer, C.Leaf, P.Orvaschel, H.Anthony, J.Boyd, J.Burke, J.Kramer, M. & Stolzman, R. (1984) Six-months’ prevalence of psychiatric disorders in three communities. Arch. Gen. Psychiatry 41, 959967CrossRefGoogle ScholarPubMed
Perse, J. & Lebeaux, M.O. (1977) Manuel du Minimult. Centre de Psychologie Appliquée, ParisGoogle Scholar
Persson, G. & Nordlund, G. (1985) Agoraphobics and social phobics: differences in background factors, syndrome profiles and therapeutic responses. Acta Psychiat. Scand. 71, 148159CrossRefGoogle Scholar
Rathus, S. (1973) A thirty-item schedule assessing assertive behavior. Behav. Ther. 4, 298306CrossRefGoogle Scholar
Sheehan, D. & Sheehan, K. (1982) The classification of phobic disorders. Int. J. Psychiatry Med. 12, 4, 243266CrossRefGoogle ScholarPubMed
Solyom, L.Ledwidge, B. & Solyom, C. (1986) Delineating Social Phobia. Brit. J. Psychiatry 149, 464470CrossRefGoogle ScholarPubMed
Thorpe, G. & Burns, L. (1983) The Agoraphobic Syndrome.Wiley and Sons, New YorkGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.